Individual
DR. GARY STUART HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1770 IOWA AVE, SUITE 280, RIVERSIDE, CA 92507-2430
(951) 786-0801
(951) 786-0460
Mailing address
3651 LAKETREE DR, FALLBROOK, CA 92028-9404
(760) 723-2676
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G67633
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G67633
STATE MEDICAL LICENSE
CA
Enumeration date
06/29/2006
Last updated
10/07/2009
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